The role and efficacy of compound sodium lactate and sorbitol injection
As a pharmaceutical preparation, clinical use of compound sodium lactate and sorbitol injection requires strict adherence to indications. This product contains a multi-component composite system of sodium lactate, sodium chloride, potassium chloride, and sorbitol, mainly used to regulate the balance of water and electrolytes in the body and correct mild acidosis. Specifically, sodium lactate can be converted into bicarbonate through liver metabolism, effectively neutralizing excess acidic substances in the body. The matching sodium and potassium ions jointly maintain normal osmotic pressure and stable cardiac rhythm, while the dehydration and diuresis properties of sorbitol help alleviate tissue edema.
This type of injection is usually suitable for surgical patients with volume deficiency or for the treatment of metabolic acidosis caused by acute gastroenteritis. It should be noted that the patient's condition must be evaluated by a specialist nephrologist before clinical application. The infusion rate should be controlled during use, with a standard of 2.5 milliliters per kilogram of body weight per hour. Elderly individuals or patients with circulatory system dysfunction should reduce the rate. The focus of monitoring is on the dynamic observation of changes in respiratory frequency and arterial blood gas values.
When the patient's blood sodium concentration exceeds 145mmol/L and blood potassium concentration exceeds 5.5mmol/L, the use of this preparation is prohibited. Patients with severe renal insufficiency, anuria, or uncorrected shock should not use this medication. Special populations such as pregnant women in cycles 24-35 and high-risk postpartum women must undergo consultation and evaluation with obstetrics and gynecology to avoid the risk of worsening preeclampsia.
Special attention should be paid to compatibility taboos during the preparation process, such as not being able to infuse drugs with acid sensitivity such as Dexmedetomidine and Penicillin Sodium in the same bottle. When using fat emulsion injection, it is necessary to observe whether there is layering phenomenon. After mixing drugs, they should be stored in an environment below 30 ℃. After opening, the storage period at 4-15 ℃ should not exceed seven days. It is worth emphasizing that changing the drug concentration without authorization can lead to abnormal osmotic pressure, especially in pediatric patients who may experience dehydration of brain cells under insufficient dilution.
At present, clinical application information for drugs shows that more than 0.5% of medication patients may experience sudden rash or injection site flushing symptoms. In this case, medication should be immediately suspended and recorded with the pharmacy department. In recent years, it has been reported that long-term misuse of the drug in patients with diabetes is likely to induce glucose metabolism disorder. Therefore, the pharmacy department must double check the parameters of the hypoglycemic treatment plan in the medical record system when executing medical orders.
Pharmacists need to focus on providing patient guidance in three areas. Firstly, it is necessary to confirm that there is no hidden history of starch allergy, as the modified starch in the excipients of this product has slight antigenicity. Guide patients to monitor for numbness at the extremities during infusion, and promptly report any electrolyte displacement symptoms to medical staff. For individuals with high sensitivity, it is advisable to start using small doses and conduct lymphocyte subpopulation gene testing to screen for specific responses.
According to the warning announcement issued by the Medical Device Administration in 2022, this product cannot be used in combination with other nutritional infusion tubes through intravenous catheters in detention centers. Patients with a history of portal hypertension may experience liver metabolic overload due to intravenous infusion. During treatment, it is recommended to undergo routine five item liver function tests. At the pharmaceutical monitoring level, for critically ill patients who have already undergone tracheal intubation, it is necessary to implement a micro pump to strictly control the total amount of infusion.

At present, the children's specific diluent of this product has obtained a provisional approval number. Patients aged 3-8 should adjust the parameter configuration plan according to the children's version instructions.
The drug development department needs to pay attention to the progress of new generation alternative products. The improved composite electrolyte solutions that have been launched in recent years have replaced some of the sorbitol components with more easily metabolized sodium sorbate, effectively avoiding drug interference caused by false positive urine routine occult blood. This optimization direction is worthy of industry tracking. Some medical institutions have begun to develop a maximum safe cycle model for the continuous use of this injection. Currently, animal experiments have shown that intravenous infusion for 9 consecutive days did not cause acute kidney injury. Clinical value research is currently undergoing multi center parallel controlled observation.
In terms of rational drug use, emphasis is placed on individualized prescription strategies, and it is recommended to establish a multidisciplinary drug consultation process for key departments. For patients with a sharp increase in creatinine levels in the ICU ward, special attention should be paid to medication adjustments. When serum potassium increases by more than 1.3 millimoles within 24 hours, a low potassium compatibility regimen should be replaced. Practice in the field of rehabilitation medicine has shown that the combined use of this drug in fluid resuscitation treatment for patients with traumatic brain injury can reduce the probability of acute pulmonary edema by 7.6 percentage points.
For grassroots medical institutions in remote areas, a "Guidelines for Monitoring the Infusion of Compound Solutions" has been specially compiled to present the standard for handling typical medication problems in a Q&A format. For example, when dealing with the case of severe sodium retention due to drug misuse in patients after mixed hemorrhoid surgery, it is required to immediately transfuse the compound naloxone hydrochloride balance solution with low concentration of sodium to correct the deviation. At the township health center level, a centrifugal plasma viscosity meter must be installed to ensure that diagnostic and treatment plan correction prompts are issued in advance in case of abnormal routine biochemical testing.
The monthly report of regional adverse reaction density maps for various dosage forms by the National Adverse Drug Reaction Testing Platform is of great significance. The Q4 2022 report shows that the number of itching cases caused by the infusion of this product in high humidity coastal areas is 83% higher than that in inland provinces. This is highly consistent with the basic theory that air humidity enhances cell membrane permeability and needs to be taken into account as a regional adjustment parameter for the impact of bioavailability. It is also necessary to regularly review the expiration date and sterilization quality reports of drugs, as prolonged storage of carbonated drugs may produce formic acid metabolites.
Finally, it is necessary to pay attention to the construction of the medical quality control system in the application safety chain of such solutions. Establish a three-level verification process in the outpatient and emergency infusion room, and use an artificial intelligence system to assist in scanning drug codes and patient wristband information for electronic prescription comparison, significantly reducing the risk of medication mismatch in a digital mode. Use a translucent calibration card to mark the liquid phase stratification status of routine backup drugs for rescue vehicles every month, ensuring that the proportion of drug components meets the basic requirements of bioequivalence under any storage conditions, and comprehensively guaranteeing the safety of patient treatment.